Mobile medical drug management systems and methods

ABSTRACT

Mobile systems and methods are adapted to control and document prehospital patient care reports and communication of patient status to a receiving medical treatment facility. The systems and methods relate to systems and methods for managing, recording, and administering drugs such as narcotics in an ambulatory and/or emergency environment.

CROSS REFERENCE TO RELATED APPLICATION

This application claims the benefit of U.S. Provisional Application No.62/669,154 filed May 9, 2018, the contents of which is incorporatedherein by reference in its entirety and for all purposes.

STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSOREDRESEARCH AND DEVELOPMENT

This invention was made with Government support under W911W6-12-D0005,DO 0004. The Government has certain rights in the invention.

BACKGROUND

The present disclosure relates to documentation of prehospital patientcare reports and communication of patient status to a receiving medicaltreatment facility. In current systems, ambulatory medical careproviders, such as military medics, typically use pen and paper and/oran occasional radio call to a receiving medical treatment facility toreport patient care data and status. This often results in inaccuratereporting of patient medical data.

For example, in the case of the administration of drugs to a patient, amilitary medic must often mentally do weight-based medical dosage mathin guessing the patient's weight for proper dosage of drugs. Such medicsare often required to do this math during high stress missions, usuallywith multiple trauma patients. This can often result in inaccuratedosages.

In addition, the medical care provider typically must write and/ormaintain a log of narcotic use post-mission. The medical care providermay suffer penalties, such as job or pay loss, if the narcotics log isfound to be inaccurate. Moreover, the medic care provider is typicallyissued pre-mission, loose drug vials in a hand-held case with acommercial off-the-shelf key lock to maintain drug security. During themission, the medic must hold these very small vials in his/her hands andmust often try to insert the needle in a very high vibration environmentof either an air or ground MEDEVAC. Finger sticks, loss of drug vials,over/under-dosing of patients are common and unfortunate occurrences.

SUMMARY

In view of the foregoing, there is a need for improved systems andmethods for documentation of prehospital patient care reports andcommunication of patient status to a receiving medical treatmentfacility particularly with respect to management of drugs such asnarcotics. Disclosed are mobile systems and methods for documentation ofprehospital patient care reports and communication of patient status toa receiving medical treatment facility. In one aspect of the disclosure,the systems and methods relate to systems and methods for managing,recording, and administering drugs such as narcotics in an ambulatoryand/or emergency environment.

The systems and methods include a drug rack that includes variousfeatures for securely managing the administration of drugs. The drugrack is particularly suited for an environment outside of a hospitalsuch as a prehospital environment. It can be used on military oremergency missions and is particularly suited for the harsh andunpredictable environments of such missions.

In an embodiment, the drug rack is communicatively and/or mechanicallycoupled to a weight-based drug calculator to assist in proper,weight-based dosage of drug by a medical provider. The rack alsoincludes one or more mechanisms for securing the drugs pre/during/postmission for accountability and safer usability. This also adds safetymeasures to assist the care provider in selecting the proper drug duringthe mission. The system is also configured to maintain a log of thedrugs pulled from the rack or otherwise manipulated for improved andaccurate post-mission drug inventory. The system can also maintain anaccurate and up-to-date patient health record.

In an embodiment, the drug rack includes one or more slots or seats thatcan contain standard-issue drug vials or containers, such as painmanagement, sedative, and paralytic vials (for example, 10 mLmulti-dose, and 2 mL single-dose vials). The rack also includes asecurity mechanism, such as lock bar, to secure entry or access to thedrug rack for mounting and unmounting the drug vials. The lock bar doesnot necessarily inhibit access to the vials for fluid withdrawal. Asdescribed below, the drug rack includes a primary security mechanism formedication withdrawal from the vials in the form of small access doors.Under normal use cases, these doors cannot be manually opened withoutgaining access via a software interface. Rather, the user must rely onan associated software interface to obtain access to the contents of thedrug vials.

In addition, the rack includes one or more identifiers, such as lightemitting diode (LED) indicators, that assist a medical care provider inidentifying a proper drug for use with a patient. The drug rack may alsoinclude an electronic and/or mechanical access feature, such as one ormore access doors, that automatically open to assist the medical careprovider in accessing and identifying which drug vial was selected foradministration on the patient. The access doors may automatically openwhen a corresponding drug is selected via a software user interface.

The system may include or otherwise be coupled to software that providesrecommended dosages, and software buttons to open the access door(s) tothe associated drug on the rack, which also illuminates an indicatorlight. The software buttons aid in the security of the drugs in that auser must have access to a user device, such as a tablet, and also beproperly logged in as an authorized medic in order to activate the doorsof the drug rack. In an example, an additional software button may beused to record the drug given and to also close the access door to thedrug vial. The recorded drug's actual volume and dosage may beautomatically captured during this process. The system may also be usedscan the type of drug in the vial holder and to also automaticallymeasure an amount of drug that was actually pulled from the vial. Thesystem can also include wireless communication capabilities, such as forexample, Bluetooth and Ultra-Wideband wireless connectivity to the drugrack and to a remote location.

More details of the devices, systems and methods are set forth in theaccompanying drawings and the description below. Other features andadvantages will be apparent from the description and drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other aspects will now be described in detail with referenceto the following drawings. The figures are not necessarily to scale inabsolute terms or comparatively but are intended to be illustrative.Also, relative placement of features and elements may be modified forthe purpose of illustrative clarity.

FIG. 1 shows a schematic representation of a system for documentationand management of prehospital patient care reports and communication ofpatient status to a receiving medical treatment facility.

FIG. 2 shows a mobile container system that can be carried by a medicalcare provider for use in missions such as military and emergencymissions outside of a hospital.

FIG. 3 shows a drug rack that can be coupled to the mobile containersystem.

FIG. 4 shows a mounting clip for the drug rack of a mobile medicationmanagement system. The drug rack itself may also be referred to as amobile medication management system or as a portion thereof.

FIG. 5 shows the drug rack mounted to Modular Lightweight Load-carryingEquipment (“MOLLE”).

FIGS. 6 and 7 show bottom views of the drug rack.

FIG. 8 shows an example user interface of the system.

FIGS. 9 and 10 show perspective views of another embodiment of a drugrack.

FIGS. 11 and 12 show the drug rack of FIGS. 9 and 10 with a lid in anopen state.

DETAILED DESCRIPTION

Disclosed are systems and methods for documentation of prehospitalpatient care reports and communication of patient status to a receivingmedical treatment facility (i.e., a medical treatment facility that willreceive a patient.) As mentioned, the system includes a drug rack thatcan be used to securely manage the storage, access, and distribution ofdrugs such as narcotics. The drug rack is portable and can be carried bya user, such as a medic, in connection with missions such as militaryand emergency missions.

FIG. 1 schematically shows an exemplary, high-level representation of asystem for documentation and management of prehospital patient carereports and communication of patient status to a receiving medicalfacility 120. The system includes a mobile container system 105 (alsoreferred to as a transport telemedicine system), which is described inmore detail below with reference to FIG. 2. The mobile container system105 is of a size such that it can be carried by a person, such as amedical care provider (e.g., a medic). The mobile container system 105is also sized to be carried and transported in a mobile vehicle 110,such as a helicopter. The mobile container system 105 includes or can becoupled to a communication device, such as a wireless transmitter, thatenables the mobile container system 105, to communicate with the medicalfacility 120, such as via communication with a satellite 150 and/orcommunication over a communication network such as the Internet.

In an example embodiment, the mobile container system 105 or any othercomponent of the system is configured to communicate pursuant to thefeatures described in the following U.S. patent applications, which areincorporated by reference in their entirety: (1) U.S. patent applicationSer. No. 15/803,220 entitled “EXTENDED RANGE COMMUNICATIONS FORULTRA-WIDEBAND NETWORK NODES” and filed on Nov. 3, 2017; and (2) U.S.patent application Ser. No. 15/650,095 entitled “MULTI-BROKER MESSAGINGAND TELEMEDICINE DATABASE REPLICATION” and filed on Jul. 14, 2017.

The system of FIG. 1 provides access to a user interface 125 that canprovide user interaction with data collected by the mobile containersystem 105. Such interaction can include, for example, viewing the dataas well as entering and modifying data. The user interface shown in FIG.1 is a dashboard-like interface to be used by remote care providers togain an overview of the condition and status of all patients associatedwith the mobile container system.

With reference still to FIG. 1, the mobile container system 105 ismechanically and/or wirelessly coupled to one or more devices 100, whichcan include a drug rack 305 (FIG. 3) that can be used to securely managethe storage, access, and distribution of drugs, as described in detailbelow.

The devices 100 can also include other types of devices, such as medicaldevice that may be connected to the device mobile container system 105either via a physical or wireless connection. The connected medicaldevice(s) may include, for example, any number and combination ofdevices such as: EKG monitor, blood pressure monitor, heart ratemonitor, ventilator, defibrillator, IV pump, EEG device, oxygen sensor,cardiovascular reserve index monitor or other similar devices.

The mobile container system 105 may be used at a point of care location,which can be any location where a care provider is providing medicalcare to a patient. In an embodiment, the point of care location is anemergency location such as a vehicle crash, battlefield or disastersite. Such environments may have limited communication capabilities thatmay adversely affect the ability to transmit data and may also haveextreme environmental conditions. The point of care location may be anylocation that is remote from the point of care location. In an example,the remote location is at least more than several miles away from themedical facility 120.

Mobile Container System

FIG. 2 shows the mobile container system 105, which includes a container210 that can be carried by a medical care provider. The mobile containersystem 105 is communicatively coupled to a user device 215, which can becontained within or otherwise coupled to the container 210. The userdevice 215 can be any type of device that the care provider uses toenter, record, store, view and/or maintain data related to the care ofthe patient. The user device 215 may be, for example, a laptop computer,mobile phone, tablet, data pad, etc. The user device 215 generallyincludes a data input element such as a keypad and/or touch screen. Inan embodiment, the device 215 includes voice recognition software thatpermits the user to verbally enter data into the device 215. In anembodiment, the user device 215 is held, controlled and/or operated byone or more transport personnel, such as a medic in an emergencyenvironment. The user can input data into the user device 215 via a userinterface. The user device 215 is configured to receive data from auser, wherein the data may relate to aspects of the patient, such asheight, weight, blood pressure, or any data related to the patient.

FIG. 2 also shows other possible components such as an Athena GTX WVSMpatient care device, which provides the following telemetric values: 3lead ECG/EKG, Blood Pressure, SPO2 and heart rate. Another component caninclude a biomodule device, such as a Zephyr BioModule, which providesrespiration rate, 2 lead ECG/EKG, and Accelerometer data.

As mentioned, a communication component may be coupled to the mobilecontainer system 105. The communication component can be any device thatis configured to transmit data to a remote location via a communicationlink, such as a line of sight, satellite or any other type of wirelesscommunication link to the remote location. The communication link mayinclude the Internet, public switched telephone network (PSTN), aprivate network, etc. The communication component may include any of avariety of communication devices that are configured to transmit data.For example, the communication component may include one or moreantennas, modems, amplifiers, radios, or other types of transceivers,etc. The communication component enables the mobile container system 105to transmit data from a database via wireless transmission (e.g., radio)to an external network in accordance with configured specifications,with the end user being another party such as a medical facility.

Drug Rack

As mentioned, the mobile container system 105 includes the drug rack305, which is configured to manage the storage, access, and distributionof drugs. FIG. 3 shows a perspective view of an example embodiment ofthe drug rack 305. The drug rack 305 includes an outer housing 310 thatis sized and shaped to contain and/or store one or more drug vials 315.The outer housing 305 can be any of a variety of shapes including therectangular shape shown in FIG. 3. In a non-limiting example embodiment,the drug rack 305 has a size of 5 inches wide by 2.5 inches tall, by 2.5inches deep and weighs no more than about 0.6 pounds. In anotherembodiment described below, the drug rack 305 is contained within orotherwise includes a housing with a lid that can be opened to exposedcontents of the drug rack 305.

In the illustrated embodiment, the drug rack 305 is sized to containfour drug vials 315, which can be of equal or varying size relative toone another. In an example, the vials can be 10 mL multi-dose or 2 mLsingle-dose vials although the size of the vials can vary. It should beappreciated that the housing 310 can be sized to contain any quantity ofvials although the preference is that the quantity be limited so thatthe housing is of a size than can be transported and/or easily carriedby a user. In an example embodiment, the housing 310 contains no morethan three, four, five, six, and up to ten vials although this may vary.

The housing 310 is configured such that it defines at least one slot orseat for each of the drug vials 315. The seats can be configured toreceive therein a drug vial of various sizes, such as a large drug vialand a smaller drug vial. The drug vials 315 are arranged in one or morerows of drug vials as shown in FIG. 3 although the spatial arrangementof the drug vials can vary. A retaining member, such as a lock bar 320is movably attached to the housing 310 such that, in a closed state, thelock bar 320, retains or secures the vials 315 within their respectiveseats in the housing 310. The lock bar 320 can move relative to thehousing 310, such as in a pivoting or rotating manner, to an open statewherein the lock bar 320 does not impede or otherwise prevent the drugvials 315 from being removed from the housing 310. The lock bar 320 ispositioned such that a vial, when seated in its seat, is interposedbetween the lock bar 320 and the seat so that the lock bar 320 preventsthe vial from being removed from the seat when the lock bar is properlypositioned.

The drug rack 305 can include a single lock bar 320 that collectivelysecures all the drug vials 315 as shown, or it can include a separate,dedicated lock bar for each of (or a subset of) the drug vials in thedrug rack 305. The lock bar 320 can be lockingly secured in the closedstate such as via a mechanical or electromechanical lock for security ofthe drugs contained within the drug rack 305.

With reference still to FIG. 3, the drug rack 305 can include a mountingclip 325 that is attached to the housing 310. The mounting clip 325 canbe used to secure or otherwise mount the drug rack 305 to anotherobject. FIG. 4 shows the mounting clip 325 and FIG. 5 shows the drugrack 305 mounted to a MOLLE as an example.

FIG. 6 shows a bottom view of the drug rack 305. FIG. 7 shows a bottomview with the drug rack being partially transparent so as to illustrateinternal components of the drug rack. As shown in FIG. 6, an opening orport 605 is associated with each of the drug vials 315 at the bottomwall of the housing. Each port 605 provides an accessway by which auser, such as a medic, can access the contents of the respective drugvial 315. Each port 605 can transition between an open state and aclosed state. Port 605 a is shown in the open state while port 605 b isshown in the closed state. When the port is in the open state, thecontents of the respective drug vial are accessible by the user. When inthe closed state, the contents of the respective drug vial areinaccessible by the user, as described below. The port(s) can include orbe coupled to mechanical and/or electrical components, such as one ormore electro-mechanical servo devices that enable control of theport(s).

The transparent view of FIG. 7 shows an example mechanism by which theports 605 can transition between the open and closed states. Each port605 has an associated door 705 that is movably positioned within thedrug rack 305. Each door 705 can slidably transition between the closedstate wherein the door 705 covers or otherwise blocks the respectiveport, and an open state wherein the door 705 does not cover or otherwiseblock the respective port. In FIG. 7, the door 705 a is in the openstate while the remainder of the doors 705 are in the closed state.

The drug rack 305 can include electromechanical components that arecoupled to the doors 705 and the lock bar 320 for controlling thesecomponents between the open and closed states. The drug rack can alsoinclude software to automatically control these components, such as viainteraction with a user and/or based upon satisfaction of predeterminedconditions. In addition, the drug rack 305 can include features such alights, sounds, and tactile feedback to provide the user withindications as to the availability of the drug, type of drug, dosageinformation for the drug, how much drug has been used, etc.

The drug rack can include, for example, one or more multi-color LED drugindicator lights that provide a color coded back light depending on thetype of drug contained in the vials. For example, the lights can becolor-coded such as Blue/Pain, Orange/Sedative, Purple/Paralytic.

The software can be coupled to a user interface, such as the exampleuser interface shown in FIG. 8. The user interface can include datarelated to the drug vials and can also include features that enable theuser to interact with the drug rack, such as to open/close/lock/unlockfeatures of the drug rack. The access doors and/or the lock bar can beconfigured via software to automatically open after the care providerselects a drug to administer via the user interface. The software canalso include a weight-based recommended drug calculator that can readweight automatically from a digital/wireless scale coupled to thesystem. The drug rack software can also automatically detect the drugtype in a vial via a bar code scan and also the volume/dosage pulledfrom a vial.

FIGS. 9 and 10 show perspective views of another embodiment of the drugrack 305. This embodiment includes an outer housing 910 with a movablelid 920 that transitions between an open and closed state. When in theclosed state, the lid 920 covers the drug vials so as to prevent accessto the drug vials. When in the open state, the lid does not cover thedrug vials and does not prevent access to the drug vials. Rather, thelid provides a platform or surface that provides a location where a usercan place instruments, such as needles, when accessing the drug vials.FIGS. 9 and 10 show the lid 920 in the closed state. In an exampleembodiment, the lid 920 is at least partially made of a transparentmaterial such that a user can view the drug vials contained therein evenwhen the lid is closed. As shown in FIG. 9, the drug rack 305 caninclude components such as a power (or “on/off”) switch 925. The drugrack 305 can also include a port 930, such as a USB port, for chargingthe drug rack and or coupling a USB device to the drug rack 305.

As shown in FIG. 9, the outer housing 910 and lid 920 can include aninterface such as a pair of holes through which a tie element can beinserted and tied for locking the lid closed. The outer housing 910 canalso include other components such as magnets for securing the lid 920in the closed state.

As shown in FIG. 10, the drug rack 305 can include a tighteningmechanism 1005 that a user can actuate to tighten and to also releasetension on one or more elongated members such as cables or wires 1012(or other actuation component) that individually or collectively serveas a retaining member or locking element for vials contained within thedrug rack 305, as described more fully below. The wires 1012 wrap aroundvials contained within the drug rack 305 and can be tightened tolockingly secure the vials within the drug rack 305. In an embodiment,the tightening mechanism includes a ratcheting device that can beactuated, such as via rotation or other movement, to place the wires intension and/or release the wires from tension. In a non-limitingexample, the ratcheting device includes a rotatable knob.

FIG. 11 shows the drug rack 305 with the lid 920 in the open statewherein the lid is open relative to the outer housing 910 so as toexpose the vials 315. In FIG. 11, the drug rack 305 is in an exampleorientation in which a user, such as a medic, can use the drug rack 305.The lid 920 is coupled to the outer housing 910 via one or more hinges1105 that enable the lid 920 to rotate between the open state and theclosed state. It should be appreciated that other mechanisms aside fromrotatable hinges can be used to enable the transition of the lid betweenthe open and closed states.

The lid 920 defines a flat or substantially flat, horizontal platform orsurface 1110 that defines a space where a user, such as a medic, canrest his or her hands as the vials are being accessed. The surface 1110also provides a platform upon which the user can also place one or moreitems, such as a needle. The flat surface 1110 aids in the medicinserting a needle into a vial such as during a high vibrationenvironment. The lid 920 and/or the outer housing 910 can include one ormore securing elements, such as magnets, to maintain the lid 920 in anopen or closed state. The vials 315 are positioned relative to thesurface 1110 such that ends of the vials 315 are facing and immediatelyadjacent to the surface 1110. That is, an open or access portion (suchas where a needle can be inserted) of the vial 315 is immediatelyadjacent the surface 1110, such as abutting and/or contacting thesurface or within an inch or two of the surfaces. This permits the userto easily access both the surface 1110 and the vials 315.

As mentioned with respect to the prior embodiment, each vial 315 isseated within a corresponding slot or seat. When seated as such, thedrug rack 305 orients each vial 315 so that a top portion or accessportion of the vial is presented to a user for convenient access. Theseat can be shaped to correspond or complement the shape of the vial sothat the vial can sit flush within the respective seat. Each vial has acorresponding saddle 1120 that abuts, grabs, or otherwise stabilizes orthe vial when seated in its seat. The saddle 1120 can be tightened aboutits respective vial to lock the vial within its seat. The saddle 1120can be made of a material that is flexible or malleable such that thesaddle can conform to the shape of the respective vial when the saddleis tightened over the vial.

As mentioned, the saddles 1120 can be tightened about their respectivevials to lock the vials within their seats. In this regard, the wires1012 (FIGS. 10 and 11) are threaded through the saddles and alsothreaded through at least a portion of the drug rack so as to secure thedrug vials 315 relative to the drug rack. The wires 1012 can be placedin tension to exert a force that constrains the saddles 1120 and theirrespective vials in place within their seats. The actuator 1005 (FIG.10) can be used to tighten and release the tension on the wires 1012. Ina non-limiting embodiment, the actuator 1005 is part of a tighteningmechanism, such as the tightening mechanism described in U.S. Pat. No.5,934,599, which is incorporated herein by reference in its entirety.

FIG. 12 shows another view of the drug rack 305. The lid and a portionof the outer housing are not shown in FIG. 12 for clarity ofillustration. As mentioned, the drug rack 305 can include one or moremulti-color LED drug indicator lights that provide a color coded backlight depending on the type of drug contained in the vials. As shown inFIG. 12, the one or more LEDs 1205 can be located on the drug rack 305at or near a bottom region of each vial 315. When illuminated, an LEDemits light through a clear bottom region of the drug vial. The lightrefracts in the material of the vial (such as glass) and within thematerial inside the vial (such as liquid) so as to make the vial glow.The drug rack can include infrared capabilities and/or night visioncapabilities that utilize infrared LEDs for illumination of the vial(s).

In a method of use, a user, such an emergency medic, is transported viaa mobile vehicle 110 to a location that requires medical treatment for apatient. The location can be an emergency location such as a disastersite or a battle site. The user can carry the mobile container system105 or a portion thereof during transport or can also mount the mobilecontainer system 105 on the vehicle. Upon reaching a location, the usercan carry the mobile container system 105 or a portion thereof on his orher body without assistance from a transport device such as a cart. Theuser can then treat a patient by accessing the user interface. The usercan gain access to the contents of one or more drug vials of the drugrack via interaction with the user interface, which may requestcredentials or other security access requirements. Upon accessing thecontent(s) of the drug vial(s), the mobile container system 105 canlocally or remotely records or otherwise memorialize data related to thedrug or contents accessed via the vial. For example, the system canrecord, via the drug rack, that a specific drug was administered at acertain time, the time the drug was given, the name or other datarelated to the patient, the dosage amount, etc.

One or more aspects or features of the subject matter described hereinmay be realized in digital electronic circuitry, integrated circuitry,specially designed ASICs (application specific integrated circuits),computer hardware, firmware, software, and/or combinations thereof.These various implementations may include implementation in one or morecomputer programs that are executable and/or interpretable on aprogrammable system including at least one programmable processor, whichmay be special or general purpose, coupled to receive data andinstructions from, and to transmit data and instructions to, a storagesystem, at least one input device (e.g., mouse, touch screen, etc.), andat least one output device.

These computer programs, which can also be referred to programs,software, software applications, applications, components, or code,include machine instructions for a programmable processor, and can beimplemented in a high-level procedural and/or object-orientedprogramming language, and/or in assembly/machine language. As usedherein, the term “machine-readable medium” refers to any computerprogram product, apparatus and/or device, such as for example magneticdiscs, optical disks, memory, and Programmable Logic Devices (PLDs),used to provide machine instructions and/or data to a programmableprocessor, including a machine-readable medium that receives machineinstructions as a machine-readable signal. The term “machine-readablesignal” refers to any signal used to provide machine instructions and/ordata to a programmable processor. The machine-readable medium can storesuch machine instructions non-transitorily, such as for example as woulda non-transient solid-state memory or a magnetic hard drive or anyequivalent storage medium. The machine-readable medium can alternativelyor additionally store such machine instructions in a transient manner,such as for example as would a processor cache or other random-accessmemory associated with one or more physical processor cores.

To provide for interaction with a user, the subject matter describedherein can be implemented on a device having a display device, such asfor example a liquid crystal display (LCD) monitor for displayinginformation to the user and a keyboard and a input device, such as forexample a mouse or a trackball, by which the user may provide input tothe device. Other kinds of devices can be used to provide forinteraction with a user as well. For example, feedback provided to theuser can be any form of sensory feedback, such as for example visualfeedback, auditory feedback, or tactile feedback; and input from theuser may be received in any form, including, but not limited to,acoustic, speech, or tactile input. Other possible input devicesinclude, but are not limited to, touch screens or other touch-sensitivedevices such as single or multi-point resistive or capacitive trackpads,voice recognition hardware and software, optical scanners, opticalpointers, digital image capture devices and associated interpretationsoftware, and the like.

The subject matter described herein can be embodied in systems,apparatus, methods, and/or articles depending on the desiredconfiguration. The implementations set forth in the foregoingdescription do not represent all implementations consistent with thesubject matter described herein. Instead, they are merely some examplesconsistent with aspects related to the described subject matter.Although a few variations have been described in detail above, othermodifications or additions are possible. In particular, further featuresand/or variations can be provided in addition to those set forth herein.For example, the implementations described above can be directed tovarious combinations and subcombinations of the disclosed featuresand/or combinations and subcombinations of several further featuresdisclosed above. In addition, the logic flow(s) when depicted in theaccompanying figures and/or described herein do not necessarily requirethe particular order shown, or sequential order, to achieve desirableresults. Other implementations may be within the scope of the followingclaims.

1. A handheld drug rack system, comprising: a housing defining at leastone seat sized to receive therein a drug vial, wherein the housing issized to be held by a user; a retaining member coupled to the housingand positioned such that a vial, when seated in the at least one seat,is interposed between the retaining member and the at least one seat sothat the retaining member prevents the vial from being removed from theat least one seat; and a port that provides an accessway by which a usercan access the contents of a respective drug vial.
 2. The drug racksystem of claim 1, wherein the retaining member comprises at least onewire that at least partially wraps the drug vial.
 3. The drug rack ofclaim 2, wherein the retaining member includes a tightening mechanismthat can be actuated to place the at least one elongated member intension.
 4. The drug rack of claim 1, wherein the retaining membercomprises an actuator that can be rotated to place the at least oneelongated member in tension.
 5. The drug rack of claim 1, wherein theretaining member comprises a bar that can be moved into a lockedposition to lock the drug vial in the seat.
 6. The drug rack of claim 1,wherein the at least one seat includes a plurality of seats, and whereineach seat in the plurality of seats is sized to receive a drug vial. 7.The drug rack of claim 6, wherein each seat is sized to contain a vialof various sizes.
 8. The drug rack of claim 1, further comprising a doorthat covers the port to prevent access of the at least one drug vial. 9.The drug rack of claim 8, wherein the door can movably transitionbetween a closed state wherein the door covers or otherwise blocks theport, and an open state wherein the door does not cover or otherwiseblock the respective port.
 10. The drug rack of claim 1, furthercomprising a lid movable attached to the housing.
 11. The drug rack ofclaim 10, wherein the lid transitions between a closed state and an openstate.
 12. The drug rack of claim 11, wherein the lid, when in the openstate, defines a horizontal platform.
 13. The drug rack of claim 12,wherein the horizontal platform is positioned immediately adjacent thevial.
 14. The drug rack of claim 1, wherein the port is coupled to amechanical-electrical servo to control access to a respective vial. 15.The drug rack of claim 4, wherein the actuator includes a ratchetingdevice.
 16. The drug rack of claim 1, wherein drug rack is configured torecord data related to access of a drug vial.
 17. The drug rack of claim16, wherein the data includes a time that a vial is accessed and a nameof a patient.
 18. The drug rack of claim 1, wherein the drug rack iscoupled to software that controls the drug rack.